Provider Demographics
NPI:1578937629
Name:SHARP, ALYSSA (MS, RD, CDCES)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:SHARP
Suffix:
Gender:F
Credentials:MS, RD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11429 HERITAGE GREEN DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-7402
Mailing Address - Country:US
Mailing Address - Phone:260-804-7540
Mailing Address - Fax:
Practice Address - Street 1:11429 HERITAGE GREEN DR
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-7402
Practice Address - Country:US
Practice Address - Phone:260-804-7540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-29
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered